Overlap of diseases underlying ischemic stroke: the ASCOD phenotyping
Détails
ID Serval
serval:BIB_9C7B5F311EDB
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Overlap of diseases underlying ischemic stroke: the ASCOD phenotyping
Périodique
Stroke
ISSN
1524-4628 (Electronic)
ISSN-L
0039-2499
Statut éditorial
Publié
Date de publication
09/2013
Peer-reviewed
Oui
Volume
44
Numéro
9
Pages
2427-33
Langue
anglais
Notes
Sirimarco, Gaia
Lavallee, Philippa C
Labreuche, Julien
Meseguer, Elena
Cabrejo, Lucie
Guidoux, Celine
Klein, Isabelle F
Olivot, Jean-Marc
Abboud, Halim
Adrai, Valerie
Kusmierek, Jerome
Ratani, Samina
Touboul, Pierre-Jean
Mazighi, Mikael
Steg, Philippe Gabriel
Amarenco, Pierre
eng
Research Support, Non-U.S. Gov't
Stroke. 2013 Sep;44(9):2427-33. doi: 10.1161/STROKEAHA.113.001363. Epub 2013 Jul 16.
Lavallee, Philippa C
Labreuche, Julien
Meseguer, Elena
Cabrejo, Lucie
Guidoux, Celine
Klein, Isabelle F
Olivot, Jean-Marc
Abboud, Halim
Adrai, Valerie
Kusmierek, Jerome
Ratani, Samina
Touboul, Pierre-Jean
Mazighi, Mikael
Steg, Philippe Gabriel
Amarenco, Pierre
eng
Research Support, Non-U.S. Gov't
Stroke. 2013 Sep;44(9):2427-33. doi: 10.1161/STROKEAHA.113.001363. Epub 2013 Jul 16.
Résumé
BACKGROUND AND PURPOSE: ASCOD phenotyping (A, atherosclerosis; S, small vessel disease; C, cardiac pathology; O, other causes; and D, dissection) assigns a degree of likelihood to every potential cause (1 for potentially causal, 2 for causality is uncertain, 3 for unlikely causal but disease is present, 0 for absence of disease, and 9 for insufficient workup to rule out the disease) commonly encountered in ischemic stroke. We used ASCOD to investigate the overlap of underlying vascular diseases and their prognostic implication. METHODS: A single rater applied ASCOD in 405 patients enrolled in the Asymptomatic Myocardial Ischemia in Stroke and Atherosclerotic Disease study. RESULTS: A was present in 90% of patients (A1=43% and A2=15%), C in 52% (C1=23% and C2=14%), and S in 66% (S1=11% and S2=2%). On the basis of grades 1 and 2, 25% of patients had multiple underlying diseases, and 80% when all 3 grades were considered. The main overlap was found between A and C; among C1 patients, A was present in 92% of cases (A1=28%, A2=20%, and A3=44%). Conversely, among A1 patients, C was present in 47% of cases (C1=15%, C2=15%, and C3=17%). Grades for C were associated with gradual increase in the 3-year risk of vascular events, whereas risks were similar across A grades, meaning that the mere presence of atherosclerotic disease qualifies for high risk, regardless the degree of likelihood for A. CONCLUSIONS: ASCOD phenotyping shows that the large overlap among the 3 main diseases, and the high prevalence of any form of atherosclerotic disease, reinforces the need to systematically control atherosclerotic risk factors in all ischemic strokes.
Mots-clé
Aged, Aged, 80 and over, Atherosclerosis/diagnosis/*epidemiology, Brain Ischemia/classification/diagnosis/*epidemiology, Cardiovascular Diseases/classification/diagnosis/*epidemiology, Comorbidity, Female, Heart Diseases/diagnosis/epidemiology, Humans, Male, Middle Aged, *Phenotype, Prognosis, Risk, Stroke/classification/diagnosis/*epidemiology, atherosclerosis, etiology, stroke
Pubmed
Open Access
Oui
Création de la notice
28/02/2018 15:47
Dernière modification de la notice
20/08/2019 16:03